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Stephen F. Dierdorf

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date: 23 June 2021

Calcium is critical to many vital physiologic functions. These functions include cardiac rhythm and contractility, neuromuscular transmission, and skeletal muscle contractility. 45% of the calcium in the blood is ionized, which is more revalent to the physiologic function of calcium as opposed to the fraction that is bound. Serum ionized calcium levels are closely regulated by the parathyroid gland via calcium-sensing receptors and parathormone secretion. Low or high levels of calcium can result in life-threatening cardiac dysrhythmias and skeletal muscle weakness leading to respiratory failure. The anesthesiologist must be aware of the clinical conditions that place patients at risk for calcium abnormalities. This will allow for early recognition of the signs and symptoms, so that measurements can take place and rapid treatment can be given.

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